Brief Body Notes - The purinergic hypothesis of migraine


A migraine often presents as an intense throbbing or pulsing sensation on one or both sides of the head, it is frequently accompanied by sensitivity to light and sound, nausea and vomiting. 

Migraines are commonly associated with triggers: hormonal changes, food and additives, stress, sleep, physical and sensory factors, changes in the environment and certain medications.

There is also research that suggested that the sensitization of the periosteum may contribute to migraine symptoms (Schueler et al. 2014). Central to this pathological phenomenon involves extracellular purinergic signalling (Yegutkin et al. 2016).

What is Purinergic Signalling?

ATP is primarily an energy source, but it can also act as a signalling molecule. Sensory nerves receive messages carried by ATP, impulses may be activated by ATP or inhibited by adenosine. These signaling molecules can be released from different types of cell (e.g., osteoblasts, fibroblasts, endothelial, epithelial,and glial cells) in response to mechanical stimulation.

Interesting enough with this condition, manual therapy or acupuncture may activate its degradation product adenosine which plays an anti-nociceptive role as it binds to the widespread neuronal inhibitory A1 receptors (Tang et al. 2016)

More to Explore

Bove, G. (2013). Lending a hand to migraine. Pain.

Borea, P. A., Gessi, S., Merighi, S., & Varani, K. (2016). Adenosine as a Multi-Signalling Guardian Angel in Human Diseases: When, Where and How Does it Exert its Protective Effects? Trends in Pharmacological Sciences.

Happe, S., Peikert, A., Siegert, R., & Evers, S. (2016). The efficacy of lymphatic drainage and traditional massage in the prophylaxis of migraine: A randomized, controlled parallel group study. Neurological Sciences.

Jacobs, B., & Dussor, G. (2016). Neurovascular contributions to migraine: Moving beyond vasodilation. Neuroscience.

Ji, R.R., Chamessian, A., Zhang, Y.Q. (2016). Pain regulation by non-neuronal cells and inflammation. Science. (OPEN ACCESS)

Olesen, J., Burstein, R., Ashina, M., & Tfelt-Hansen, P. (2009). Origin of pain in migraine: Evidence for peripheral sensitisation. The Lancet Neurology.

Sawynok, J. (2016). Adenosine receptor targets for pain. Neuroscience.

Schueler, M., Messlinger, K., Dux, M., Neuhuber, W. L., & De, R. (2013). Extracranial projections of meningeal afferents and their impact on meningeal nociception and headache. Pain.

Schueler, M., Neuhuber, W. L., Col, R. D., & Messlinger, K. (2014). Innervation of Rat and Human Dura Mater and Pericranial Tissues in the Parieto-Temporal Region by Meningeal Afferents. Headache: The Journal of Head and Face Pain.

Schwedt, T. J. (2014). Chronic migraine. BMJ.

Tang, Y., Yin, H., Rubini, P., & Illes, P. (2016). Acupuncture-Induced Analgesia: A Neurobiological Basis in Purinergic Signaling. The Neuroscientist.

Yegutkin, G. G., Guerrero-Toro, C., Kilinc, E., Koroleva, K., Ishchenko, Y., Abushik, P., . . . Giniatullin, R. (2016). Nucleotide homeostasis and purinergic nociceptive signaling in rat meninges in migraine-like conditions. Purinergic Signalling. (OPEN ACCESS)